Post-op rehabilitation program for ACJ reconstruction


Problem: ACJ dislocation with reduced range of movement and shoulder pain

Aim: to stabilise ACJ, increase range of movement and reduce pain

Important points: to remain in sling for four weeks



● heavy activities or heavy work before 12 weeks

● no heavy activities or sport above shoulder height and arm pulled back for 3 months (ABER position)



● return to desk jobs at 3-6 weeks

● driving at 6-10 weeks (if pain and function allows safe driving)

● breaststroke swimming at 10 weeks

● contact sports and freestyle swimming at 4 months


Physiotherapy protocol day 1 onward:

● Ensure adequate pain relief, neuro-vascular status normal and no signs of infection

● Hand and elbows exercises

● Pendulums and circles

● Active external rotation and internal rotation

● Shoulder shrugs and scapular exercises

● Sling for first 4 weeks Physiotherapy protocol day 21 onward:

● Begin to wean out of sling over next 3 weeks

● Begin active assisted forward flexion and abduction


Physiotherapy protocol week 7 onward:

● Active range of movement throughout

● Once achieved concentrate on scapular control and strength exercises


Protocol from 4 months onward:

● Return to sports and full activities if regained full ROM and 90% strength of contra-lateral side


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